Organization
ADVANCED MEDICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HADDAR ICHILOV P.T. (ADMINISTRATOR)
(602) 439-3800
Entity
Organization
Contact information
Practice address
15640 N 7TH ST STE 6, PHOENIX, AZ 85022-3538
(602) 439-3800
Mailing address
16075 W LINCOLN ST, GOODYEAR, AZ 85338-2828
(218) 966-0700
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11525
AZ
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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